Individual provider Active NPI

Monyca R Harris-Champion, O.T.

  • Occupational Therapist
  • Franklin, TN
National Provider Identifier
1073514501
Registry record updated Jul 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3073 Issued in TN
Practice address
324 Cool Springs Blvd
Franklin, TN 37067-1631
Phone
(615) 791-7257
Fax
(615) 591-6336
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3073 TN Primary

Addresses

Primary practice location

324 Cool Springs Blvd
Franklin, TN 37067-1631

Mailing address

324 Cool Springs Blvd
Franklin, TN 37067-1631
Phone (615) 791-7257

Other identifiers 1

IdentifierTypeStateIssuer
3656538MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140305002139 TN Practitioner - Occupational Therapist in Private Practice 8325004401 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3073TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Champion Healthcare LLC CurrentSince Apr 1, 2016 Accepting new patients
Darryl Champion PastSince Apr 1, 2016 Accepting new patients

Locations

324 N Maple St
Lebanon, TN 37087
Phone (615) 547-4205

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501113600000",
    "number": "1073514501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 COOL SPRINGS BLVD",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370671631",
            "telephone_number": "615-791-7257",
            "fax_number": "615-591-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 COOL SPRINGS BLVD",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370671631",
            "telephone_number": "615-791-7257",
            "fax_number": "615-591-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS-CHAMPION",
        "first_name": "MONYCA",
        "middle_name": "R",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2017-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "3073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3656538",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.